Tooth extraction can be defined as the removal of a tooth from its socket in the bone.

Normally, whenever there is a tooth breakage or tooth damage due to tooth decay the dentist try and repair the tooth by various means such as filling, fixing a crown etc. However, there are times at which the tooth damage is so much that it cannot be repaired and under such circumstances he has no choice other than extracting the tooth. This is the common reason for tooth extraction.

You must understand that it is always better to save the tooth as far as possible.

In addition to the above there are a number of other reasons that necessitate extraction of tooth. These are as follows:

• Cancer Drugs - if the person is taking drugs for cancer his immune system will be weakened by the cancer drugs thereby increasing his risk for infection. In such cases infected tooth needs to be extracted.
• Dental Caries - although the incidence of dental caries has reduced considerably it is still the main reason for extraction of non-third molar teeth.
• Extra teeth - Situations where a person has extra teeth that block other teeth coming in warrants tooth extraction.
• Fractured tooth - if the teeth is fractured
• Gum Diseases – if a person is suffering from severe gum disease it will affect the bone structure as well as supporting tissues thereby necessitating extraction of tooth.
• Organ transplant - the risk of infection of persons receiving an organ transplant is quite high because the drugs that they take weakens the immune system and some teeth of such persons that are infected need to be extracted.
• Orthodontics treatment – if the person has to be treated by fixing braces it may be necessary to extract the tooth for providing space for movement of teeth.
• Radiation treatment - if the person is getting radiation treatment either to the head or neck requires extraction of tooth that comes in the field of radiation
• Wisdom Tooth – these are called third molars and normally come either during late teens or early 20s. Quite often these teeth get stuck in the jaw and do not come in. If these teeth are decayed or cause pain they need to be extracted. Sometimes other teeth block the wisdom teeth or wisdom teeth do not have enough space to come in. This could result in gum irritation, swelling and pain and requires tooth removal.

There are two main categories of tooth extractions – simple and surgical. Details are given below.

• Simple extraction - these are performed on teeth that are externally visible in the mouth and can easily be done by general dentists. The dentist gives a local anesthetic injection before he extracts the tooth. The dentist uses two tools - elevator to lift and loosen the tooth and forceps for extracting the tooth.
• Surgical extraction or Open extraction- these are performed on teeth that are not possible to be accessed easily; this could happen if the teeth are broken under the gum line or partial eruption of the teeth. In such a case the surgeon has to cut and pull back the gums thereby providing access to removing the bone or a piece of the tooth.

Prior to extraction of your teeth your oral surgeon or dentist will find out about your medical and dental histories. In order to decide on the best method of extraction the surgeon will take an X-ray of the area.

Your doctor might prescribe antibiotics to be taken pre and post surgery depending on the following.

• If your tooth is infected at the time of surgery
• If your immune system is weak
• If the surgery will take a longer time
• If you suffer from a specific medical conditions

You might have to wear short sleeves to facilitate placing IV line in a vein.

The post-extraction instructions can be downloaded and viewed by clicking on the following link:

Click here to download the post-extraction instructions

Click here to download consent form

The following problems might occur because of extraction of tooth

• Infection - it is possible that the extracted area might get infected if you have a weak immune system; the dentist might prescribe antibiotics both prior to extraction and post extraction.
• Extended bleeding - you might notice small quantity of blood mixed with saliva post operation and this phenomenon is normal. In certain cases it might last as long as 72 hours after extraction of the tooth. However, in most of the cases bleeding will stop within 8 hours of surgery.
• Swelling - this depends mainly on the extent of surgery performed to extract a tooth. In general, while elevating a surgical flap you will notice minor to moderate swelling. More swelling could occur if the soft tissue flap is cut poorly.
• Dry Socket - this occurs when the blood clot does not form in the hole or the blood clot breaks off or breaks down too early. If there is a dry socket the bone underneath gets exposed to air and food. This not only is painful but also results in bad odor or taste.
• Nerve injury - this normally happens while extracting third molars; however this can occur with any tooth where the nerve is closer to the surgical site. The nerves affected are – inferior alveolar nerve and the lingual nerve. These injuries can occur during lifting of the teeth; however it occurs when damage is caused by a surgical drill accidentally. Normally these injuries are rare and temporary, but in certain cases it could be prolonged or permanent.
• Tooth damage - there is every possibility that the tooth fillings or tooth nearer to the surgical site gets damaged accidentally.
• Incomplete Extraction - in this case the root remains in the jaw and in order to prevent infection of the root your dentist might remove the root.
• Fractured jaw - this is the result of application of pressure on the jaw while extracting the tooth; this normally happens in old people having osteoporosis (thinning) of the jaw.
• Hole in the sinus - a hole appears when your upper back tooth – molar – are removed; if the hole is small it will close in a few weeks automatically otherwise more surgery will be required.
• Sore jaw muscles/ jaw joint - sometimes you may find it difficult to open your mouth wide. This could be because of the injections, keeping your mouth open as well as lots of pushing on your jaw.
• Numbness in the lower lip and chin - this happens when there is an injury to the inferior alveolar nerve while removing the lower wisdom teeth. This might take 3-6 months for healing in most of the cases; in some cases this could permanent.